Techniques, anaesthesia preferences, and outcomes of Achilles tenotomy during Ponseti method of idiopathic clubfoot correction: A systematic review

Rangasamy, Karthick; Baburaj, Vishnu; Gopinathan, Nirmal Raj; Sudesh, Pebam

doi:10.1016/j.foot.2022.101922

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…Biomechanical function and long-term results in children treated with the Ponseti method in the middle childhood were closer to those in healthy individuals than in children treated with surgery alone [23]. An important aspect of the Ponseti™ casting technique is Achilles tendon amputation (AT) [24][25][26] to obtain a flexible foot rather than a fully corrected foot [27]. We analyzed and discussed the correlation of plaster correction times, age of first visit, gender, and birthplace of patients in the department and understood their correlation and causality.…”

Section: Introductionmentioning

confidence: 99%

[Retracted] Retrospective Case Analysis of 104 Cases of Talipes Equinus

Tan

Yang

Liu

et al. 2022

Journal of Environmental and Public Health

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A retrospective study of 104 patients (81 male and 23 females, the age range from 2 to 288days) with talipes equinus was conducted to explore the case factors associated with it. We analyzed and discussed the correlation of plaster correction times, age of first visit, gender, and birthplace of patients in the department and understood their correlation and causality. The data were analyzed using frequency analysis, normality test, chi-square goodness-of-fit test, chi-square test, and PLS regression. The findings are set out below. All the distributions of the number of plaster casts in the samples did not have normality. Therefore, we used the nonparametric test and partial least squares regression (PLS regression) and found that the number of plaster casts was more closely related to the age at first visit, gender, and birthplace and had a strong positive correlation. There was a negative correlation between the times of plaster correction and the compliance of braces. The lower the compliance of patients with braces, the more times the plaster correction will be conducted.

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Section: Introductionmentioning

confidence: 99%

[Retracted] Retrospective Case Analysis of 104 Cases of Talipes Equinus

Tan

Yang

Liu

et al. 2022

Journal of Environmental and Public Health

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“…An important consideration is that the infants were at all times accompanied by their parents, which produces a calming effect. This consideration is corroborated by Rangasamy et al [15], for whom the best methods of non-medicated sedation include the presence of the parents, breastfeeding or formula feeding, and skin-to-skin contact. However, the latter study did not include a comparative analysis of the benefit produced.…”

Section: Discussionmentioning

confidence: 82%

“…A systematic review by Rangasamy et al [ 15 ] concluded that percutaneous tenotomy under local anesthesia, as an outpatient procedure, was both safe and preferable to general anesthesia, which they consider unnecessary, as there are no significant differences in the outcomes produced, while outpatient care has a much lower financial cost and is not associated with long-term adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Acute Stress in Infants Undergoing Percutaneous Achilles Tenotomy for Clubfoot vs. Peripheral Line Placement

Ey Batlle,

Jordan,

Miguez Gonzalez

et al. 2024

Children

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Introduction: Percutaneous tenotomy of the Achilles tendon is a procedure that is part of the Ponseti method for clubfoot correction. The need to apply general anesthesia or sedation for this procedure is controversial. The objective of this study is to compare the acute stress generated in infants by percutaneous Achilles tenotomy under local anesthesia vs. peripheral line placement. Material and methods: This cross-sectional study compares the discomfort experienced by 85 infants undergoing percutaneous Achilles tenotomy with local anesthesia with that experienced by 39 infants undergoing peripheral line placement. The following parameters were determined: the duration of the procedure, crying time, average crying intensity, and maximum crying intensity. Other data recorded included the infant’s age and complications arising during the procedure. Results: The mean ages of these patients were 1.95 and 2.18 months, respectively. The following data were obtained: the mean duration of the procedure for Group A was 8.13 s and for Group B it was 127.43 s; the mean duration of crying for Group A was 84.24 s and for Group B it was 195.82 s; the mean intensity of crying for Group A was 88.99 dB and for Group B it was 100.98 dB; and the maximum crying intensity for Group A was 96.56 dB and for Group B it was 107.76 dB. Conclusions: Percutaneous Achilles tenotomy can be safely performed as an outpatient procedure, under local anesthesia. This method generates less discomfort than peripheral line placement.

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A single-center, single-blinded, randomized, parallel-group, non-inferiority trial to compare the efficacy of a 22-gauge needle versus a 15 blade to perform an Achilles tendon tenotomy in 244 clubfeet—study protocol

Pigeolet,

Ghufran Syed,

Ahmed

et al. 2023

Trials

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Background Achilles tendon tenotomy is an integral part of the Ponseti method, aimed at correcting residual equinus and lack of dorsiflexion after correction of the adductus deformity in clubfoot. Percutaneous tenotomy using a number 15 scalpel blade is considered the gold standard, resulting in excellent results with minimal complications. The use of a large-bore needle to perform Achilles tendon tenotomies has been described in literature, but a large-scale randomized controlled trial is currently lacking. In this trial, we aim to show the non-inferiority of the needle tenotomy technique compared to the gold standard blade tenotomy technique. Methods We will randomize 244 feet into group A: needle tenotomy or group B: blade tenotomy. Randomization will be done using a block randomization with random block sizes and applying a 1:1 allocation to achieve an intervention and control group of the exact same size. Children will be evaluated at 3 weeks and 3 months post-tenotomy for primary and secondary clinical outcomes. The primary clinical outcome will be the range of dorsiflexion obtained the secondary clinical outcomes will be frequency of minor and major complications and Pirani score. The non-inferiority margin was set at 4°, and thus, the null hypothesis of inferiority of the needle technique will be rejected if the mean difference between both techniques is less than 4°. The statistical analysis will use a multi-level mixed effects linear regression model for the primary outcomes and a multi-level mixed effects logistic regression model for the secondary clinical outcomes. The physician performing the evaluations post-tenotomy will be the only one blinded to group allocation. Trial registration This trial was registered prospectively with ClinicalTrials.gov registration number: NCT04897100 on 21 May 2021.

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Techniques, anaesthesia preferences, and outcomes of Achilles tenotomy during Ponseti method of idiopathic clubfoot correction: A systematic review

Cited by 4 publications

References 39 publications

[Retracted] Retrospective Case Analysis of 104 Cases of Talipes Equinus

[Retracted] Retrospective Case Analysis of 104 Cases of Talipes Equinus

Comparative Study of Acute Stress in Infants Undergoing Percutaneous Achilles Tenotomy for Clubfoot vs. Peripheral Line Placement

A single-center, single-blinded, randomized, parallel-group, non-inferiority trial to compare the efficacy of a 22-gauge needle versus a 15 blade to perform an Achilles tendon tenotomy in 244 clubfeet—study protocol

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